Drug reference

Imipenem with cilastatin

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 570, 571

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Aerobic and anaerobic Gram-positive and Gram-negative infections (not indicated for CNS infections) | Hospital- acquired septicaemia ▶BY INTRAVENOUS INFUSION ▶Adult: 500 mg every 6 hours, alternatively 1 g every 8 hours Infection caused by Pseudomonas or other less sensitive organisms | Empirical treatment of infection in febrile patients with neutropenia | Life-threatening infection ▶BY INTRAVENOUS INFUSION ▶Adult: 1 g every 6 hours DOSE EQUIVALENCE AND CONVERSION ▶Dose expressed in terms of imipenem.

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Cautions

CNS disorders. epilepsy

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Allergy And Cross Sensitivity

Avoid if history of immediate hypersensitivity reaction to beta-lactam antibacterials. Use with caution in patients with sensitivity to beta- lactam antibacterials.

PDF page 570

Safety

Interactions

→Appendix 1: carbapenems

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Side Effects

▶Common or very common Diarrhoea. eosinophilia. nausea. skin reactions. thrombophlebitis. vomiting ▶Uncommon Bone marrow disorders. confusion. dizziness. drowsiness. hallucination. hypotension. leucopenia. movement disorders. psychiatric disorder. seizure. thrombocytopenia. thrombocytosis ▶Rare or very rare Agranulocytosis. anaphylactic reaction. angioedema. chest discomfort. colitis haemorrhagic. cyanosis. dyspnoea. encephalopathy. ﬂushing. focal tremor. gastrointestinal discomfort. haemolytic anaemia. headache. hearing loss. hepatic disorders. hyperhidrosis. hyperventilation. increased risk of infection. myasthenia gravis aggravated. oral disorders. palpitations. paraesthesia. polyarthralgia. polyuria. pseudomembranous enterocolitis. renal impairment. severe cutaneous adverse reactions (SCARs). spinal pain. tachycardia. taste altered. tinnitus. tongue discolouration . tooth discolouration. urine discolouration. vertigo ▶Frequency not known Agitation

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Pregnancy

Manufacturer advises avoid unless potential beneﬁt outweighs risk (toxicity in animal studies).

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Breast Feeding

Present in milk but unlikely to be absorbed.

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Renal Impairment

Manufacturer advises avoid if creatinine clearance less than 15 mL/minute. Dose adjustments Manufacturer advises reduce dose if creatinine clearance less than 90 mL/minute (risk of CNS side-effects)—consult product literature. l EFFECT ON LABORATORY TESTS Positive Coombs’ test.

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Dose and formulations

Directions For Administration

For intravenous infusion dilute to a concentration of 5 mg (as imipenem)/mL in Sodium chloride 0.9%; give up to 500 mg (as imipenem) over 20–30 minutes, give dose greater than 500 mg (as imipenem) over 40–60 minutes.

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Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Powder for solution for infusion ELECTROLYTES: May contain Sodium ▶Imipenem with cilastatin (Non-proprietary) Cilastatin (as Cilastatin sodium) 500 mg, Imipenem (as Imipenem monohydrate) 500 mg Imipenem 500mg / Cilastatin 500mg powder for solution for infusion vials | 10 vial P £130.30 ▶Primaxin I.V. (Merck Sharp & Dohme Ltd) Cilastatin (as Cilastatin sodium) 500 mg, Imipenem (as Imipenem monohydrate) 500 mg Primaxin IV 500mg powder for solution for infusion vials | 1 vial P £12.00

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Dose text by age group

Adult

500 mg every 6 hours, alternatively 1 g every

First-line fragment. Read the complete Indications and Dose section above.

PDF page 570

Adult

1 g every 6 hours

First-line fragment. Read the complete Indications and Dose section above.

PDF page 570

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Imipenem with cilastatin

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 570, 571

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF page 570

Cautions

CNS disorders. epilepsy

PDF page 570

Allergy And Cross Sensitivity

Avoid if history of immediate hypersensitivity reaction to beta-lactam antibacterials. Use with caution in patients with sensitivity to beta- lactam antibacterials.

PDF page 570

Safety

Interactions

→Appendix 1: carbapenems

PDF page 570

Side Effects

PDF page 570

Pregnancy

Manufacturer advises avoid unless potential beneﬁt outweighs risk (toxicity in animal studies).

PDF page 570

Breast Feeding

Present in milk but unlikely to be absorbed.

PDF page 570

Renal Impairment

PDF page 570

Dose and formulations

Directions For Administration

PDF pages 570, 571

Medicinal Forms

PDF page 571

Dose text by age group

Adult

500 mg every 6 hours, alternatively 1 g every

First-line fragment. Read the complete Indications and Dose section above.

PDF page 570

Adult

1 g every 6 hours

First-line fragment. Read the complete Indications and Dose section above.

PDF page 570

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.